Why is Croup Worse at Night ?

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If your child has a barking seal cough throughout the day and night, chances are they may have a medical condition known as Croup. Split up of two types, the viral condition of croup is similar to a common cold or flu, while the spasmodic type during bedtime can cause your child to experience heavy gasp in between coughs.

What is Croup

Croup is a contagious upper airway infection that restricts your breathing and causes coughing that sounds like a howling seal.  Laryngotracheobronchitis is croup’s medical name and means inflammation of the trachea (windpipe), larynx (voice box and bronchioles (airways of the lungs). Croup generally occurs in small children and isn’t usually serious. In fact, you can treat most cases of croup at home.

A virus infection like a parainfluenza virus can cause croup. Children can breathe infected respiratory droplets either sneezed or coughed into the air which is how they contract a virus. The droplet virus particles can also survive on surfaces and toys. When your child picks up that toy or touches a contaminated surface and then touches their nose, eyes or mouth, they can get the infection.

Signs and Symptoms of the Croup

Croup symptoms are often more severe in kids under 3 years old since they have a smaller respiratory system than adults. Common symptoms of croup include:

Barky cough

A loud, croup cough that often wakes the child from their sleep, frightening both the child and their parents.

Hoarse voice:

Caused by voice box swelling.

Fever: 

A fever below 104 often accompanies croup.

Common cold symptoms: 

These cold virus symptoms may come before the croup or linger on afterward.

Stridor:

Stridor is a raspy, harsh, gasping, whooping sound your child makes when they’re breathing in.

If you’ve never experienced croup or it’s your first time hearing your child with the barky seal cough, you may want to rush to the emergency department right away, especially during the night. Croup is notorious for becoming worse at night. This is likely due to the voice box swelling and changes in blood flow to the respiratory tract when your child is lying down. Also, dry air from heaters may worsen croup at night.

If it isn’t serious, you can usually get through the night with some simple home remedies. Your child’s symptoms will improve a little, but then get worse the next couple of nights. This commonly happens and in most cases, still doesn’t require any special medications.

Treatment for the Croup

Croup can be unsettling and uncomfortable for your child. To make your child more comfortable you can try the following home remedies:

  • Keeping your child calm.

  • Moisten the air with a cool-mist humidifier.

  • Taking your child outdoors in the fresh air for around 15 minutes.

  • Sit in the bathroom with them, turn shower on, close bathroom door and let them sit in the steam.

  • Giving your child fluids.

  • Propping your child’s head up with an extra pillow while they sleep.

You may even want to think about having your child sleep in the same room with you during the first couple days so you’ll know when they start having problems breathing and you can help right away before it gets worse.

If your child’s croup doesn’t respond to your home remedy attempts or gets serious, you’ll need to bring them to the pediatrician for treatment. A few treatment options may include:

Steroid treatment

— Glucocorticoid for reducing inflammation in the airway.

Anti-inflammatory medication

— Dexamethasone is long-lasting with effects lasting up to 72 hours.

Epinephrine

— Also reduces airway inflammation effectively.

Closely monitor your child’s breathing, especially at night. Usually, croup just sounds scary and doesn’t warrant a trip to the ER. However, it can get severe where your little one will require immediate treatment.

Watch out for things such as:

  • Face or lips turning a bluish color while your child is coughing

  • Breath retractions causing your child’s ribs to draw in with each inhale

  • Fever over 104° F

  • Severe chest pain

  • Compromised immunity — weakened immune system

Croup typically lasts three to seven days, sometimes longer. Symptoms are often worse on the second night. But, the prognosis of children with croup is good. Rarely will children require steroid medication and even rarer is a child requiring hospitalization. Most children tend to get back to good health after around a week.  If your child’s croup doesn’t clear up, see your child’s pediatrician, pediatric pulmonologist or ENT doctor.

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